Austa Clinicas

What Austa Clinicas does

Austa Clínicas (legal entity: AUSTACLINICAS ASSISTENCIA MÉDICA E HOSPITALAR LTDA – CONVÊNIO AUSTA) is a Brazilian private health insurance operator (operadora de planos de saúde) founded in 1980 and headquartered in São José do Rio Preto, São Paulo, with 501–1,000 employees. The company is regulated by the Agência Nacional de Saúde Suplementar (ANS) under Lei 9.656/98 and serves individual, family, corporate, and dental plan beneficiaries, alongside home-care (SAD) and digital services.

Its core product is the Medida Certa coparticipation plan, offered alongside standard enfermaria (shared room) and apartamento (private room) tiers, with add-on services including orthopedic products via CENEMED, rescue and inter-hospital transport, medication discounts (up to 35% at Drogão Super and up to 15% at compounding pharmacies), and maternal-care support via the Evah Saúde partnership. The proprietary technology stack includes the Portal do Beneficiário, Portal do Prestador, Portal da Empresa, the P.A. Digital urgent care service, and a TISS 3.0.2 compliant web service for standardized ANS data exchange. Care delivery is anchored by the company's own Austa Hospital and an accredited regional hospital network, supplemented by ABRAMGE membership for national emergency/urgency coverage across 21 Brazilian states with access to 107,000+ affiliated physicians.

The business model combines recurring monthly premiums (subscription) with usage-based coparticipation fees and small subscription add-ons (e.g., R$ 4.99/month for orthopedic products), maintaining 1,000+ active contracted plan variations. Go-to-market is a hybrid motion: a commercial sales team and broker/administrator network drive enterprise and affinity-group sales, while digital self-service portals and WhatsApp handle existing beneficiary servicing, quote requests, and account management. The company holds LGPD compliance via an appointed data protection officer and publishes annual IDSS results as part of ANS's Programa de Qualificação de Operadoras.

Name

Austa Clinicas

Legal name

AUSTACLINICAS ASSISTENCIA MÉDICA E HOSPITALAR LTDA – CONVÊNIO AUSTA

Website

https://austaclinicas.com.br

Company type

Private

Founded year

1980

Operating status

Operating

Headcount range

501–1,000 employees

Short description

Austa Clínicas is a Brazilian ANS-regulated health insurance operator headquartered in São José do Rio Preto, offering individual, family, corporate, and dental plans supported by its own Austa Hospital, a regional provider network, and ABRAMGE national emergency coverage.

Ownership category

akta.pro rank

Product category

Health Insurance

NAICS

Health and Welfare Funds (525120), General Medical and Surgical Hospitals (622110)

SIC

Hospital & Medical Service Plans (6324), Accident & Health Insurance (6321), Services-Hospitals (8060)

akta.pro primary industry

International / Expatriate Group Health Plans (FSAIAFAJ)

akta.pro secondary industry

Hospital Shared Services, GPOs & System Support Organizations (HLAFAAAO)

Keywords

• Health insurance plans
• Corporate health benefits
• Coparticipation health plans
• Home care services
• Medical provider network

Headquarters

HQ city

São José do Rio Prêto

HQ country

Brazil

HQ region

Latin America

Offices4 records

Markets served

GTM type

B2B and B2C

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Supply Chain, Marketing or Sales, Infrastructure

Revenue model

1. Health Insurance Premiums: Monthly health insurance premiums paid by individual, family, and corporate beneficiaries. The company offers plans with and without coparticipation (coinsurance), with monthly billing for active policies.
2. Coparticipation Fees: When beneficiaries utilize healthcare services (consultations, exams, treatments), they pay a small predefined copay (coparticipação) as defined in their contract. This reduces the base monthly premium while generating usage-based revenue.
3. Orthopedic Products Add-on: Additional monthly fee of R$ 4.99 per enrolled client for orthopedic medical equipment and supplies through the CENEMED partnership.

Pricing tiers

Go-to-market motion2 records

Distribution channels5 records

Marketing channels8 records

Core offering

AUSTACLINICAS ASSISTENCIA MEDICA E HOSPITALAR LTDA operates as a Brazilian health insurance operator (operadora de planos de saúde) regulated by ANS, offering individual, family, and corporate health plans. The company provides plans with and without coparticipation (Medida Certa copay model), operates its own hospital (Austa Hospital), and delivers care through an affiliated network of physicians, clinics, and regional hospitals. Supplemental services include home care (SAD), emergency rescue and inter-hospital transport, medication discounts, and maternal support through Evah Saúde.

Product overview

Austa Clínicas is a Brazilian health insurance operator (operadora de planos de saúde) headquartered in São José do Rio Preto, SP, offering individual, family, and corporate health plans. The core product is the Medida Certa plan with copayment options, providing access to a network of hospitals including the proprietary Austa Hospital and regional partner facilities. The portfolio includes add-on services such as home health support (SAD), emergency rescue and transport, orthopedic products, and medication discounts. Digital services encompass beneficiary, provider, and corporate portals, plus TISS data exchange. Strategic partnerships extend coverage nationally via ABRAMGE and provide specialized maternal care through Evah Saúde.

Differentiator

Problem solved

Functional benefit

Brands

• Medida Certa: Coparticipation health insurance plan with lower monthly premium where beneficiaries pay a small predefined fee when using services.
• SAD – Suporte de Assistência Domiciliar

Products and services

• Medida Certa

Quantifiable outcome

• Medication discounts of up to 35% at partner pharmacy chains
• +1 more outcomes

Segments3 records

Ideal customer profiles2 records

Technology focussed No

API detail

Has API

Yes

API docs

API detail

Core technology

AI maturity

App detail

Integration2 records

Feature4 records

Partnerships

Six partnerships are on record, tiered core and minor.

• Evah SaúdecoreStrategic or Co-development Partner · 1 June 2024Evah Saúde is a maternal health platform offering personalized support for pregnant women through WhatsApp and online tools. Austa Clínicas partnered with Evah Saúde to provide its beneficiaries with a safer and more welcoming pregnancy journey, including multidisciplinary care teams (doctors, nurses, nutritionists), educational content, and health monitoring. The service is free for Austa Clínicas beneficiaries.
• ABRAMGE (Associação Brasileira de Medicina de Grupo)coreStrategic or Co-development PartnerABRAMGE is a non-profit association of medical group companies. Austa Clínicas, as an ABRAMGE member, provides its beneficiaries with national emergency and urgency coverage through the ABRAMGE network spanning 21 Brazilian states. The 'Urgência Abramge' program provides zero-cost emergency care for beneficiaries traveling outside their home region, with 107,000+ affiliated physicians and no waiting periods for emergency diagnosis.
• Drogão Super (Pharmacy Chain)minorGTM or Marketing PartnerPartner pharmacy chain offering up to 35% medication discounts to Austa Clínicas beneficiaries who present their health insurance card. Multiple store locations listed in São José do Rio Preto.
• Certa Farmácia de ManipulaçãominorGTM or Marketing PartnerCompounding pharmacy partner offering up to 15% medication discounts to Austa Clínicas beneficiaries.
• Alquimia Farmácia de ManipulaçãominorGTM or Marketing PartnerCompounding pharmacy partner offering up to 15% medication discounts to Austa Clínicas beneficiaries.
• Grindélia Farmácia de ManipulaçãominorGTM or Marketing PartnerCompounding pharmacy partner offering up to 15% medication discounts to Austa Clínicas beneficiaries.

Scale indicators3 records

Recent moves6 records

Expansion highlights5 records

Direct peers

• Unimed: Brazil's largest cooperative health plan system, organized as regional Unimed singulares. Closely comparable to Austa's regional-operator model with owned hospital/clinic infrastructure serving a defined catchment area.

Broad incumbents

• Hapvida NotreDame Intermédica: Largest verticalized health plan-hospital operator in Brazil following the Hapvida–NotreDame Intermédica merger. Comparable business model combining health plans with owned hospitals, but at national scale.
• Amil: Major national health insurer owned by UnitedHealth Group. Competes with Austa in corporate and individual segments and operates its own hospital network, making it a comparable vertical model at vastly larger scale.
• Bradesco Saúde: Health insurance arm of Banco Bradesco. Strong in group/corporate plans distributed via bank channels, directly comparable to Austa's corporate segment focus but at national scale.
• NotreDame Intermédica: Pre-merger verticalized health insurer-hospital operator (now under Hapvida). Directly comparable to Austa's owned-hospital-plus-plan model in terms of business architecture, though at much larger scale.
• SulAmérica: Established Brazilian health and dental insurer with national reach and corporate focus. Comparable as a multi-line health insurer selling group plans to corporates, though without Austa's regional hospital ownership.

Emerging players

• Prevent Senior: Verticalized health plan operator serving the senior segment in São Paulo with owned hospital network. Comparable model of insurer-plus-provider, though focused on a specific demographic.

Others

• Hospital Care: Brazilian hospital operator sharing digital infrastructure signals (compliance/portal links) with Austa. Listed here as an ecosystem/possibly affiliated counterpart rather than a head-to-head competitor.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat4 records

Key risks4 records

Key highlights7 records

Customer concentration

• YouTubeyoutube.com/channel/UCG09aKEIypJrN-ujWr0pkEA
• Facebookfacebook.com/austaclinicas
• LinkedInlinkedin.com/company/austa-clinicas
• Instagraminstagram.com/austaclinicas

Compliance2 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Austa Clinicas